الفهرس 
Down SyndromeOnly 14 pages are availabe for public view
 |  | from | 124 |  |  |
| | | from | 124 | | |
Abstract
It is widely acknowledged that there is a higher prevalence of thyroid disease in children and adults with DS compared with the general population (Prasher, 1999).
The various thyroid conditions associated with DS include congenital hypothyroidism, autoimmune hypothyroidism, subclinical hypothyroidism, and rarely hyperthyroidism (Tuysuz et al., 2001).
This study aimed to evaluate thyroid functions in infants and children with DS and their effect on growth and development.
The study included 100 consecutive patients with DS from the Genetics Unit, Children’s Hospital-Ain Shams University, their ages ranged between 9 months and 246 months. In all children, anthropometric measurements were assessed in the form of weight, height and BMI. IQ was assessed by Stanford Bienet test for patients >5 years old, while assessment of development in patients less than 5 years was done according to Feigelman et al. (1980). In this assessment developmental age was calculated as: last advanced skill reached / chrononical age X100. This was applied for motor, adaptive, social, and language aspects.
Blood samples were collected to measure free T4 ,TSH levels and thyroid antibodies (anti-thyroglobuin and anti-peroxidase) using standardized laboratory techniques. All tests were done by ELIZA method.
Our study revealed that subclinical hypothyroidism was found in 8 patients (8%). Thyroid antibodies were positive in one patient, only anti-thyroglobulin was positive, while anti-peroxidase was negative in all patients. None of the patients had overt hypothyroidism or overt hyperthyroidism.
Anthropometric measurements showed that Patients’ length/height percentiles ranged from (0.10 to 99.9) with mean of (20.02 ± 29.82 SD). Patient’s weights ranged from (0.10 to 99.3) with mean of (14.73 ± 24.32SD) while BMI percentiles ranged from (0.10 to 99.9) with mean of (44.5±39.39SD). It was noticed that short stature (less than -2SD) was presented in 59 patients (59%) with no significant difference between males and females.
Concerning developmental assessment, the lowest developmental milestones found in DS children was the language which was nearly 45.6 % of normal, while the highest was the social age which was 64.42% of normal.
Also no statistically significant difference between males and females as regards developmental parameters although females had slightly better developmental parameters.
As regard IQ, it was done in 22 patient aged more than 5 years and revealed that 91% had mild to moderate MR. 7 patients (32%) with mild MR, 13 patients (59%) with moderate MR and 2 patients (9%) with severe MR.
No statistically significant difference between males and females as regard TSH. There were no significant direct correlations between TSH or (length, weight, and BMI) percentiles, but statistically significant negative correlation between motor age and TSH level was found. BMI percentiles were significantly higher in females compared to males with p value of 0.04.
In this study (73%) of DS patients had congenital heart diseases. VSD was the commonest (48%) Followed by ASD (47%), PDA (17%), and Common AV canal (11%).
There was no statistically significant difference between patients with congenital heart diseases and patients with normal heart as regard anthropometric measurements and developmental parameters.
Conclusion
from this study we concluded that subclinical hypothyroidism is the most common thyroid dysfunction abnormality in DS patients (8%) .TSH had significantly negative correlation to motor age of DS patients and patients with isolated high TSH may have higher BMI values.